Laserfiche WebLink
Received I~y <br /> <br />Date __ <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> <br />'%bT,~ress <br /> <br />Electrical Firm <br />~ing Electrician <br />Electrical Contraotm ~ No <br /> <br />~ervising [ Useof ~/~¢~ <br /> Eleotrician~ No :: ¢ ~ ~¢ Building ,~ <br /> <br />~enatot Bldg. NO 225 <br />220 High Street NE <br />Salem, Oregon 97301 <br /> <br />Phone Mailing Address <br /> <br />Site No <br /> <br />Phone:: <br /> <br />Phone <br /> <br />Cross Street <br /> <br />Address:: <br /> P~. P~,*~ ~¢l 7 <br />Address <br /> <br />Home Builders Registration NO <br /> <br />Residential New <br />Commercial Alteration <br /> <br />Addition <br />Relocation <br /> <br />Occupancy <br />Change <br /> <br /> No,, RESIDENTIAL <br />____ Residence w~ring less than 1000 eq ft .... 6_'~' $ 5000 <br /> __ Residence wiring less titan 2000 eq ft e~' $ 7500 __ <br />..... Residencewidngover2000sq ft ('_~¢ $ 10500 <br />__ Electric heat installation in existing residence ~' $ 30 00 <br /> SERVICES <br />___. Temporary Construction Serwce (& $ 30 00 <br />_.__ Service change only in an existing resfdenee ¢' $ @0 00 __ <br />Commercial or Industrial: <br />Service not over 100 amperes (~i~ $ 45 00 __ <br />Service over lO0 amperes but not more than 200 amperes ~' $ 70 00 <br />__ Serviceover200amperesbutnotrnorethan400amperes ~.]'$ 10000 __ <br />.... Service over 400 amperes but not more than 600 amperes ~'¢ $ 150 00 <br />___ Service over 600 amperes ¢i~ $ 20000 __ <br />__ Service over 800 volts ¢~ $ 450 00 <br /> COMMERCIAL ,&NB INDUSTRIAl- FEEdERs <br /> Installation of Alterations or Relocation of Oistribution Feeders;; <br />__ Notmorethanl0g~mperes 4~$ 25.00 <br />Over 100 amperes but no~ more than 200 amperes (~i, $ 40 00 <br />__ Over 200 amperes but not morethan 400 amperes ('ti $ 7000 <br />__ Over400amperes ez;$ 8500 __ <br />__ Feedere'~er600vo~ts ((_~:$ 12000 <br /> MISCELLANEOUS <br />A Each trailer or mobile home space tService equipment~ (~ $ 2~00 __ <br />S Each ~upply for moPile home lCormection/ (?¢: $ 25 00 <br />__ C Eachirrigetionpump(Attachamapshowingfocation) ~.~f $ 3000 <br />D Each electric sign or outline lighting (it= $ 30 00 <br />__ E Each swimming pool(bonding) ¢~ $ 30 00 <br /> BRANCH CIRCUITS <br /> i, One new circuit; alteration or extension ~' $ 20 00 <br /> __ Two0rmorenawcircutte:alterationsore×tensio~s ¢_~$ 3000 <br />__ Other (as per NEC and Building Official) <br /> On-Site Technica. I Review (apply directly at Medea County only~ <br /> Industrial Plant Inspecgon (apply directly at Marion County only) <br /> Reinspection Fee <br /> FEE <br /> ¢~¢/,~ STATE SURCHARGE __ <br /> PLAN REVIEW FEE <br /> <br />Please return COMPLETE APPLICATION <br />with the indicated fee. <br /> <br /> INVESTIGATION FEE <br /> FLEETSURCHARGE __ ~' ~¢z-/ . <br /> TOTAL ,$ <br /> <br />SlGNATU R E O F Ap PLiOANT ~t~.~~~ <br /> <br /> HOMEOWNERS - I hereby certify that I am the owner of the property deeCribed abes, e, et which location I propose to make an electrical installation far <br /> my own use and this property is not being constructed for sale, lease or rent <br /> <br /> <br />